198021293-9-7-2023-33-CC-CGRN-CVFRA9-20230907125047

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021293
Report Date: 09/07/2023
Date Signed: 09/07/2023 12:51:01 PM

Document Has Been Signed on 09/07/2023 12:51 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	SANTA MONICA BLVD COMM CTR CHARTER HEAD START		FACILITY NUMBER:	198021293
ADMINISTRATOR:	HOUCHEN, MARCIE		FACILITY TYPE:	850
ADDRESS:	1022 N VAN NESS AVENUE		TELEPHONE:	(626) 572-5107
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90031
CAPACITY: 20	TOTAL ENROLLED CHILDREN: 20	CENSUS: 0	DATE:	09/07/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Jocelyn Tucker		TIME COMPLETED:	01:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	An announced pre-licensing site inspection was conducted today by Licensing Program Analysts (LPAs) Crystal Green and Elka Chavez to inspect and measure facility for capacity determination. Licensing staff met with Assistant Director, Jocelyn Tucker. The applicant is requesting to operate a Preschool Program with a Toddler Option Program. The proposed hours of operation will operate from Monday through Friday from 8:00 AM until 5:00 PM. This facility will be located on the premises of Santa Monica Blvd. Community Charter School. Parents will utilize Gate A located on Ridgewood Street. Children will be escorted by their parents to their designated classroom. There will be a parent board with the required postings located within each classroom. Licensing Staff was provided a tour of the facility. This facility will have a total of two classrooms which will be classroom 17 designated for the Toddler Program and classroom 19 designated for Preschool Program. Both classrooms were observed to have a separate entrance. Classroom 17 was observed to have 1 toilet and 2 sinks accessible to the toddler children. LPAs also observed a changing table located within arm’s reach of a sink within the toddler classroom. Classroom 19 was observed to have 1 toilet and 2 sinks accessible to the preschool children. All toilets and sinks are in safe and sanitary operating conditions. Furniture and equipment were inspected for age appropriateness and good repair. Individual storage space was observed located within each classroom. All classrooms were observed to contain storage area for children cots. Drinking water will be available to children via water faucet attached to the sink located within each classroom. Children will also have their personal sippy cups. There are smoke detectors and fire extinguishers located throughout the premises. The isolation area for an ill child will be located in the nurse’s office next to the main office. There is also a fully equipped first aid kit and a locking medication cabinet located in each classroom. Report Continues Page 1 of 3

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: SANTA MONICA BLVD COMM CTR CHARTER HEAD START	FACILITY NUMBER: 198021293
	VISIT DATE: 09/07/2023

NARRATIVE

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This facility will provide breakfast, lunch and snacks via the food program called Chefables. Food brought into the facility will already be prepared. This facility food prep area will be located next to classroom 19. LPAs observed the room to contains a fridge and a food warmer. No transportation will be provided by the facility.

Licensing staff was guided through the outdoor activity space. LPAs observed TK children using the outdoor activity space. Per the Facility Representative, the applicant will request a waiver to allow the preschoolers to share usage of the outdoor activity space with the TK program on a staggered play schedule. The designated Toddler area was observed to not have a fence to separate from the older children play area. Per the Facility Representative, a fence will be installed around the proposed designated toddler area. LPAs observed the outdoor area to contain picnic tables, age-appropriate play structure, and water play area. There is adequate shade provided in the outdoor play area.

Applicants was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA referred the facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
Report Continues Page 2 of 3

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: SANTA MONICA BLVD COMM CTR CHARTER HEAD START	FACILITY NUMBER: 198021293
	VISIT DATE: 09/07/2023

NARRATIVE

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LPA reviewed with applicant the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Applicants was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

The Department has received an approved Fire Clearance from the Los Angeles City Fire Department. Based on measurements obtained today, the total licensed capacity will be for twenty (20) children. The capacity for the preschool program will be 12 children and the toddler capacity will be 8 children. LPA Green discussed with the facility representative that an outdoor waiver request must be approved and the proof of correction received prior to the issuance of the license. LPA obtained pictures of the outdoor play area during this inspection.

The following correction will need to be made before receiving final approval. Correction will be due by 9/22/2023.

• The Applicant will submit proof of the fence installing around the designated outdoor toddler play area.

An exit interview was conducted with Facility Representative and a signed copy of this report was provided.

Report Ends Page 3 of 3

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

LIC809 (FAS) - (06/04)

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